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1. Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals

Author

Jamilu Tukur, Tina Lavin, Abiodun Adanikin, Muhammed Abdussalam, Kuti Bankole, Mabel Ikpim Ekott, Akaba Godwin, Halima A Ibrahim, Okonkwo Ikechukwu, Saidu Abubakar Kadas, Linda Nwokeji-Onwe, Emily Nzeribe, Taofik Oluwaseun Ogunkunle, Lawal Oyeneyin, Karima A. Tunau, Musa Bello, Is'haq Aminu, Bosede Ezekwe, Peter Aboyeji, Olubukola A. Adesina, Calvin Chama, Saturday Etuk, Hadiza Galadanci, Joseph Ikechebelu, and Olufemi T. Oladapo

Subjects
Maternal mortality, Neonatal mortality, Maternal morbidity, Quality of care, Medicine (General), R5-920
Abstract

Summary: Background: The WHO in collaboration with the Nigeria Federal Ministry of Health, established a nationwide electronic data platform across referral-level hospitals. We report the burden of maternal, foetal and neonatal complications and quality and outcomes of care during the first year. Methods: Data were analysed from 76,563 women who were admitted for delivery or on account of complications within 42 days of delivery or termination of pregnancy from September 2019 to August 2020 across the 54 hospitals included in the Maternal and Perinatal Database for Quality, Equity and Dignity programme. Findings: Participating hospitals reported 69,055 live births, 4,498 stillbirths and 1,090 early neonatal deaths. 44,614 women (58·3%) had at least one pregnancy complication, out of which 6,618 women (8·6%) met our criteria for potentially life-threatening complications, and 940 women (1·2%) died. Leading causes of maternal death were eclampsia (n = 187,20·6%), postpartum haemorrhage (PPH) (n = 103,11·4%), and sepsis (n = 99,10·8%). Antepartum hypoxia (n = 1455,31·1%) and acute intrapartum events (n = 913,19·6%) were the leading causes of perinatal death. Predictors of maternal and perinatal death were similar: low maternal education, lack of antenatal care, referral from other facility, previous caesarean section, latent-phase labour admission, operative vaginal birth, non-use of a labour monitoring tool, no labour companion, and non-use of uterotonic for PPH prevention. Interpretation: This nationwide programme for routine data aggregation shows that maternal and perinatal mortality reduction strategies in Nigeria require a multisectoral approach. Several lives could be saved in the short term by addressing key predictors of death, including gaps in the coverage of internationally recommended interventions such as companionship in labour and use of labour monitoring tool. Funding: This work was funded by MSD for Mothers; and UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO).

Published
2022
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2. Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals

Author

Jamilu Tukur, Tina Lavin, Abiodun Adanikin, Muhammed Abdussalam, Kuti Bankole, Mabel Ikpim Ekott, Akaba Godwin, Halima A Ibrahim, Okonkwo Ikechukwu, Saidu Abubakar Kadas, Linda Nwokeji-Onwe, Emily Nzeribe, Taofik Oluwaseun Ogunkunle, Lawal Oyeneyin, Karima A. Tunau, Musa Bello, Is'haq Aminu, Bosede Ezekwe, Peter Aboyeji, Olubukola A. Adesina, Calvin Chama, Saturday Etuk, Hadiza Galadanci, Joseph Ikechebelu, Olufemi T. Oladapo, Abiodun S Adeniran, Aishatu A Gobir, Amaka Ocheke, Fatimah Baba Joy, Ibrahim Rais, Amsa B Mairami, Mohammed S. Ozegya, Samuel Pam, Sarah Ango, Musa Abdulkarim Omoyine, Medupin Patricia, Silas Ochejele, Egwu Agada, Duum Nwachukwu, Grace Ahmed, Aisha Abdurrahman, Lawal M Ibrahim, Aisha Nana Adamu, Aliyu Na'uzo, Adewale Ashimi, Umma Idris, Owodunni A Adebola, Festus D Akeredolu, Asma'u Adamu, Aliyu Labaran, Adekunle Oguntayo, Abdulkadir Isa, Stephen Bature, Andeyantso E Ayuba, Hauwa Abdullahi, Zubaida L Farouk, Sulaiman Muhammad Daneji, Umar Isa, Samuel Adelaiye, Ismail M Kalle, Saidu A Kadas, Muhammad F Bashir, Joel Moruppa, Wasinda S Bulus, Usman R. Yahaya, Jalo Iliya, Abdulkarim Mairiga, Adamu Atterwahmie, Abdulhakeem Hamza, Ishaya Wanonyi, Uniga A John, Wole Ayegbusi, Adefemi Ayodeji, Zainab Imam, Opeyemi Akinajo, Iretiola Fajolu, Olufemi Akinsanya, Efeturi Agelebe, Timothy Oluwasola, Olukemi O Tongo, Olusoji Jagun, Kuponiyi Opeyemi, Olumide Kuku, Abimbola Akindolire, David O Awonuga, Iyabode Olabisi F. Dedeke, Francis Akinkunmi, Babatunde Olofinbiyi, Ogundare E Olatunde, Olufemi Aworinde, Olusoji Adeyanju, Campbell Ibijoke, Adedapo B Ande, Aniekan Abbasiatai, Eno Etim Nyong, Sunny Ochigbo, Lawrence Omo‐Aghoja, Patrick Ekpebe, Anthonia Njoku, Andrew Eigbedion, Ngozi Orazulike, Chioma Okechukwu, Solomon Igbaruma, Idemudia Ebe, Osahon Ede-Edokpolor, Amarabia Ibeawuchi, Isa Ayuba Ibrahim, Oyedeji O Adeyemi, Chukwuemeka C Mgbafulu, Onubogu C Ukamaka, Ugwu Anayochukwu, Uchenna Ekwochi, Obinna-Njoku Chioma, George Eleje, Eziamaka P Ezenkwele, Ijeoma Obumneme-Anyim, Nnabuike Ojiegbe, Nathan U Nwokeforo, Ifeanyichukwu Ezebialu, and Obiora Ejiofor

Subjects
General Medicine
Abstract

The WHO in collaboration with the Nigeria Federal Ministry of Health, established a nationwide electronic data platform across referral-level hospitals. We report the burden of maternal, foetal and neonatal complications and quality and outcomes of care during the first year.Data were analysed from 76,563 women who were admitted for delivery or on account of complications within 42 days of delivery or termination of pregnancy from September 2019 to August 2020 across the 54 hospitals included in the Maternal and Perinatal Database for Quality, Equity and Dignity programme.Participating hospitals reported 69,055 live births, 4,498 stillbirths and 1,090 early neonatal deaths. 44,614 women (58·3%) had at least one pregnancy complication, out of which 6,618 women (8·6%) met our criteria for potentially life-threatening complications, and 940 women (1·2%) died. Leading causes of maternal death were eclampsia (This nationwide programme for routine data aggregation shows that maternal and perinatal mortality reduction strategies in Nigeria require a multisectoral approach. Several lives could be saved in the short term by addressing key predictors of death, including gaps in the coverage of internationally recommended interventions such as companionship in labour and use of labour monitoring tool.This work was funded by MSD for Mothers; and UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO).

Published
2021

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